Rwanda—Proving That Funding for Family Planning Programs Gets Results

Every two years, leaders from around the world gather to discuss the global status of family planning and reproductive health. Since 2009, the International Conference on Family Planning (ICFP) has brought together scientists, researchers, policy-makers, and advocates of all ages to “disseminate knowledge, celebrate successes, and identify next steps” toward the goal of enabling an additional 120 million women to access voluntary, quality contraception by 2020.

This year’s conference was held in Kigali, Rwanda – a location chosen in recognition of the recent and varied innovations in family planning and reproductive health carried out in this Central-African country. Thanks to state-led policies and community-led behavioral programs, contraceptive prevalence has increased from around 11% percent in 2000 to 53.2% in 2015, and the country’s fertility rate has dropped to 3.9 from 6.1 over the same time period.

In addition to serving as an international platform for researchers to present new findings, ICFP hosts informational booths for organizations, schools, and advocacy groups. These booths facilitate exposure and opportunities for networking and collaboration between various stakeholders within the reproductive health community.

Population Connection staff hosted an exhibit over the course of the week-long conference to highlight some of our work and providing a platform for discussion surrounding topics like the Global Gag Rule, U.S. Support for UNFPA, the Hyde Amendment, the Helms Amendment, the Global HER Act and the #FightforHER Campaign, Title X and Trump’s Domestic Gag Rule, and United States Maternal Mortality, among others. The booth quickly became a very population attraction, and certainly kept our staff of five busy! We were excited to represent Population Connection at this international event, where we met others from all over the world who are passionately working to improve the status of reproductive health in both local and global contexts.

The entrance to Rwamagana’s community health center.

As part of the conference, I attended a site visit at the Rwamagana Health Center in the Eastern Province, located about an hour outside of downtown Kigali. Conference officials organized various tours throughout the city and the opportunity to speak with health center staff, who also gave short presentations about their respective roles. In 1995, Rwanda’s government established a program for local community members, or Community Health Workers (CHW’s), to receive the training necessary to provide education and direct reproductive and family planning services. The government also provides services such as infrastructure improvements, medical supplies, and transportation in order to to broaden the program’s scope, and in particular to reach out to Rwanda’s very at-risk and isolated rural communities.

At the local level, CHW’s provide family planning education, contraceptives, and counseling to women and young girls starting at the age of 12. The health center also offers a variety of services, including nursing consultation and hospitalization, HIV testing, care and treatment, vaccinations, antenatal care, maternity and post-natal care, and nutrition services, among many others.

Esther, a nurse at Rwamagana’s health center, waits for patients.

The program has proven to be successful in various ways throughout Rwamagana. For example, the proportion of Post-Partum family planning uptake prior to discharge at the Rwamagana hospital (which is affiliated with the health center) was recorded at 84% (64/76 deliveries) in September of 2018. That means that almost all women (including their partners) who deliver babies at the community hospital receive family planning education!

Throughout the tour, I couldn’t stop thinking about the amazing work being done in this small, rural community outside of Kigali. I’ve read countless stories about the devastating effects that certain U.S. policies have had on many places throughout Africa, and was familiar with disturbing statistics and stories related to chronic lack of access to healthcare in many parts of the continent. In fact, Population Connection and Population Connection Action Fund’s main advocacy campaign, #Fight4HER, works to permanently repeal Trump’s Global Gag Rule. Even so, my experience in Rwamagana illustrated that this community has made great progress: the health workers I spoke to were informative, knowledgeable, and well-equipped in providing comprehensive healthcare to community members who seemed eager to learn about family planning and overall health.

Health center staff talk to visitors about the comprehensive health services they’re able to offer the local community.

For too many people throughout the developing world, access to basic reproductive healthcare is often limited, with under-funded clinics lacking in critical supplies and infrastructure. However, my experience in Rwamagana illustrated that this isn’t always the case. As advocates for global development and reproductive justice, I think it’s important to emphasize localized realities and highlight positive progress being made wherever possible. In Rwamagana, I saw that people were empowered, writing their own stories and leading by impressive example. They were passionate in creating a better world for their community and their country.

Of course, this is not to say that marginalization and lack of access aren’t real problems throughout many places in Africa, including Rwanda. However, in highlighting these structural inequities, we must be careful to avoid painting in overly broad or cynical strokes. In fact, innovative and effective programs are widespread and growing. I am proud to support Population Connection’s continued advocacy in favor of increased U.S. funding for critical programs like these around the world.

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